Antibiotics

Sarcoidosis

Benefit may be obtained by using an antibiotic that is capable of attacking the bacteria which are living in the soft tissue and granuloma. The antibiotics that have been most successful against this type of bacteria are the tetracyclines. Minocycline has been proven effective in sarcoidosis. A dual regimen of low-dose Azithromycin plus Minocycline is especially effective.

The Autoimmunity Research Foundation announced at the beginning of October 2005 that its Phase 2 clinical trials had confirmed antibiotic-resistant bacteria as the cause of sarcoidosis, the deadly disease that took Reggie White’s life, and that applications for designation of three antibacterials as “Orphan Products” have been filed with the Food and Drug Administration.

The foundation has been conducting Phase 2 trials for the past three years, working with dozens of individual physicians and specialists to establish both an understanding of the pathogenesis, and of effective anti-bacterial dosing regimes. More than 200 of its patients have subsequently recovered, or are currently recovering, from this debilitating disease.

The applications to the FDA will facilitate Phase 3 trials leading to final FDA designation of these drugs for sarcoidosis.

Scleroderma

Please see the link between Scleroderma and Mycoplasma Infection.

Dermatomyositis

Dr. Thomas McPherson Brown pioneered the use of low dose antibiotics in the treatment of rheumatologic diseases. He also saw improvement in cases of mixed connective tissue disease, ankylosing spondylitis, dermatomyositis and polymyositis. Minocin (minocycline) is currently the antibiotic of choice.

IBS (Irritable Bowel Syndrome)

Researchers at Cedars-Sinai Medical Center in Los Angeles think they may have identified the cause of this mysterious and very common condition, and found an effective way to treat it. The Cedars-Sinai researchers found that 78% of the IBS patients they tested had what they called small intestinal bacterial overgrowth (SIBO), a condition in which excessive amounts of bacteria are present in the small intestine.

The researchers treated the patients who tested positive for SIBO with a 10-day course of antibiotics. Tests at the end of that time found that 25 of 47 patients had no bacterial overgrowth present, and that 12 of them had no IBS symptoms, while the symptoms were “significantly reduced” in the other 13. The symptoms were also reduced in the patients in which some SIBO was still detected, suggesting that if treatment had been continued until it was completely eliminated, perhaps with an alternative antibiotic, better results would have been obtained. (Several common drugs were used: neomycin, ciprofloxacin, flagyl, or doxycyline.)

Rifaximin, an antibiotic, appears to ease the discomfort of chronic irritable bowel syndrome (IBS), researchers report, and these healthy effects continue long after patients stop taking the drug.

Rifaximin targets bacterial “overgrowth” in the small intestine. Some researchers believe this excess bacteria is the underlying cause of many, if not all, cases of IBS.

The antibiotic is already approved by the U.S. Food and Drug Administration (FDA) for the treatment of “traveler’s diarrhea,” a non-chronic condition that affects otherwise healthy men and women.

“The striking part is that IBS patients got better and stayed better over 10 weeks after taking rifaximin for only 10 days,” said study author Dr. Mark Pimentel, director of the Gastrointestinal Motility Program at Cedars-Sinai Medical Center in Los Angeles. “This suggests that with the drug, we’re actually doing something about what’s causing IBS — which we think is bacterial overgrowth in the bowels.”

The study, conducted by Pimentel’s team, was funded by Salix Pharmaceuticals, the North Carolina-based manufacturer of rifaximin, which markets the drug under the trade name Xifaxan.

Also see the link between IBS and Test for Microbiological Imbalance.

Dysentery

Gastritis

Antibiotics are used to treat H. pylori and should be used to treat other bacterial overgrowths in the stomach as well. Since these overgrowths are usually responsible for the inflammation, eradication allows the stomach to heal and normal acid-control mechanisms to be restored. Prescription drug therapy that eliminates H. pylori infection, such as amoxicillin (Amoxil®), clarithromycin (Biaxin®), metronidazole (Flagyl®), and tetracycline (Sumycin®), in combination with the proton pump inhibitors lansoprazole (Prevacid®) and omeprazole (Prilosec®). Bismuth subsalicylate (Pepto Bismol®) may be added as well. Other medications may be prescribed to control stomach acidity, including prescription strength histamine H2 inhibitors, such as cimetidine (Tagamet®), ranitidine (Zantac®), and famotidine (Pepcid®), as well as the proton pump inhibitors omeprazole (Prilosec®), lansoprazole (Prevacid®), pantoprazole (Protonix®), and rabeprazole (Aciphex®).

Gastric/Peptic Ulcers

Please see the link between H. Pylori and Antibiotics.

Gulf War Illness

Some researchers have hypothesized that some of the veterans suffering from Gulf War illness are infected with a bacteria known as mycoplasma. A number of private physicians have reported success in alleviating Gulf War Illness symptoms using this treatment approach.

Morgellons Disease

“Cure is a word I am hesitant to use, but I have met one person who has been symptom free for about 3 years after discontinuing treatment. That person reported that they did a long-term course of high-dose antibiotic, anti-fungal and anti-helmenthic meds. Several people have claimed to be cured, but this is the only one I have personally met that has remained symptom-free for multiple years after discontinuing all treatments. I am not a physician and can give no recommendations for treatment. This person was not seen or treated by any physicians at OSU-CHS. I am merely passing this information on as a personal observation. I will keep working to try to identify the cause of Morgellons. At the moment I have no research-based, front-runners for the cause.”

With respect,

Randy S. Wymore, Ph.D.

Director, OSU-CHS Center for the Investigation of Morgellons Disease

Associate Professor of Pharmacology

Oklahoma State University

Center for Health Sciences

STD Chlamydia

Chlamydia can be easily treated with antibiotics. A single dose of azithromycin or a week of doxycycline BID are the most commonly used treatments. All sex partners must also be treated.

Ehrlichiosis

Pyelonephritis

A kidney infection should not be left to resolve on its own, but should be treated aggressively. Because they are so serious, most naturopaths will insist that you seek conventional medical care.

STD Gonorrhea

Treatment with antibiotics is effective against gonorrhea. Penicillin and tetracycline are commonly used, however some strains of gonorrhea have developed resistance to these treatments and other drugs such as ceftriaxone or spectinomycin may also be used. Often Chlamydia and gonorrhea occur simultaneously and are treated together. Always consult your physician about the treatments best for you.

Lyme Disease

Current medical therapy involves the use of antibiotics, such as doxycycline or amoxicillin. Some clinics are suggesting and offering IV antibiotic use daily over a 50 to 60 day period. Although very expensive, they feel that this is what is required in some cases. In some cases, oral antibiotics have been used continuously for as many as two years, if necessary.

Prompt treatment with antibiotics is effective in curing EARLY Lyme disease in nearly all infected people, including children. A 2003 study showed that the long-term outcome of patients with Lyme disease who are treated with antibiotic therapy is excellent. It should be noted that even if Lyme disease has been successfully treated, it may be possible to become self-reinfected with Lyme disease again at a later date. The risk appears to occur only in patients who had been treated for the rash, however. In those who developed arthritic symptoms as well, the antibody response appears to persist and prevent reinfection.

A positive Lyme blood test, even including a Western blot, does not mean that there is active disease that requires treatment. This is because blood tests can remain positive for years, even after Lyme disease has been treated or has become inactive. Occasionally, to aid in the diagnosis of Lyme disease, a sample of fluid must be aspirated (withdrawn with a sterile needle) from an affected joint. Cerebrospinal fluid may also be withdrawn from around the spinal cord through a spinal tap (lumbar puncture), so that it can be tested for the presence of Lyme-disease antibodies and inflammation, as well as to rule out other diseases.

Doxycycline has been used widely to treat all phases of Lyme disease, including erythema migrans. Doxycycline is active against Borrelia burgdorferi (the spirochete that causes Lyme disease), and it penetrates, in concentrations sufficient for eradication, virtually all body tissues that the organism may reach via hematogenous dissemination. Oral doxycycline has been shown to be as effective as parenteral ceftriaxone sodium (Rocephin) in treatment of central nervous system (CNS) Lyme disease (ie, neuroborreliosis) (1). This has tremendous cost-saving implications. In the New York area, a 3-week course of parenteral ceftriaxone for CNS Lyme disease, including administration by home care, costs between $5,000 and $7,000. In comparison, a 3-week course of oral doxycycline treatment costs only a few hundred dollars.

In addition, treatment failure in Lyme disease is seldom, if ever, seen with properly administered doxycycline regimens in EARLY Lyme disease, whereas failures are common with erythromycin therapy.

A study supported by the National Institute of Neurological Disorders and Stroke (NINDS), also a part of the National Institutes of Health, again showed that long-term antibiotic use for Lyme disease is not an effective strategy for cognitive improvement. [Neurology 70(13): 992-1003, 2008]

In about 5% of cases, symptoms persist after treatment, a condition referred to as post-Lyme disease syndrome. The treatment of post-Lyme disease syndrome is a controversial issue. Most doctors do not recommend continuing antibiotic therapy beyond 30 days. Scientific studies do not show any evidence that the benefits of long-term antibiotic treatment outweigh its risks. Long-term antibiotic treatment can lead to a serious and difficult-to-treat infection called Clostridiumdifficile, and can also cause the patient to become allergic to the antibiotic.

Babesiosis

Antibiotics are very effective, including Clindamycin, Zithromax, and Quinine being a good alternative. Clindamycin is active against organisms such as Plasmodium, Toxoplasma, Babesia, and Pneumocystis spp.

Cellulitis

Cellulitis should be treated with antibiotics to prevent its spread and complications. An untreated infection may result in gangrene, generalized blood infection, meningitis (if the face is involved) or lymphangitis. Cellulitis treatment may require hospitalization because the infection may be difficult to treat.

An antibiotic that is active against the usual disease-causing bacteria should be used. Oral Keflex (cephalexin) or Dicloxacillin is usually effective for simple cellulitis. There are other antibiotics that would probably be equally effective. A more serious infection may require the use of IV antibiotics. The response to the antibiotic should occur over several days.

Epididymitis

When a positive urine culture has identified an organism, it can be specifically treated and, as with all infections, the immune system should be supported.

MRSA

Doctors are encouraged to collect specimens for culture and antimicrobial susceptibility testing from all patients with abscesses or purulent skin lesions, particularly those with severe local infections, systemic signs of infection, or history suggesting connection to a cluster or outbreak of infections among epidemiologically linked individuals. Culture and susceptibility results are useful both for management of individual patients and to help determine local prevalence of S. aureus susceptibility to beta-lactam and non-beta-lactam agents.

Helicobacter Pylori Infection

It is not recommended to treat H Pylori with a single medication so combination therapy should always be used. There are a number of combination therapies in common use e.g. dual, triple and quadruple, but at this time the most proven effective treatment is a 2-week course of triple therapy. This involves taking two antibiotics to kill the bacteria and either an acid suppressor or stomach-lining shield. This therapy regimen reduces ulcer symptoms, kills the bacteria and prevents recurrence in more than 90% of patients.

At this time, in Austrailia, a proven and effective treatment for H. pylori is a 7-day course of medication called Triple Therapy comprising two antibiotics, amoxicillin and clarithromycin, to kill the bacteria together with an acid suppressor to enhance the antibiotic activity. This regimen of triple therapy reduces ulcer symptoms, kills H. pylori and prevents ulcer recurrence in more than 80% of patients. Antibiotic regimens recommended for patients may soon differ across regions of the world because different areas have begun to show resistance to particular antibiotics.

Nanobacteria Infection

Ciftcioglu and Kajander (confirmed later in clinical research by Mezo) found Tetracycline Hydrochloride to be the only antibiotic effective against Nanobacteria. Not even the close sisters of Tetracycline, Doxycycline and Terramycin, will work (Mezo). The larger studies have not shown Azithromycin to be effective in preventing coronary disease or in affecting it’s outcome; Azithromycin does not prevent restenosis. Tetracycline, because of its chemical structure, is able to specifically kill nanobacteria. However, effective treatment regimes are still being worked out.

Treatment may require the use, at least for now, of NanobacTX, Dr. Mezo’s Nanobiotic treatment. This is used in conjunction with tetracycline and EDTA to produce reports from cardiologists like James C. Roberts MD who say “I am seeing symptomatic improvement, often striking, in at least 90% of the patients I have treated with NanobacTX. This improvement is occurring in patients with new onset coronary symptoms, and in patients who are “too far gone” for any other standard or alternative therapies.

Cystitis, Bacterial Bladder Infection

See the E Coli Syndrome under this topic and Conventional Drugs.

Pelvic Inflammatory Disease (PID)

The main treatment of PID is antibiotics. Most often these antibiotics cure the infection, but no single antibiotic kills the bacteria that cause PID, so two or more antibiotics may be needed.

Periodontal Disease - Gingivitis

The commonly used antibiotic doxycycline (Periostat), is widely used to treat gum disease, when normal home care methods are insufficient.

Pneumonia

A serious case of pneumonia requires the use of antibiotics. A sputum culture will help determine the responsible organism and assist in antibiotic selection.

Yeast / Candida

The most common prescription medications used to treat candidiasis are Nystatin. Diflucan Fluconazole) and Nizoral. Others include Ketoconazol, Monistat (Miconazole), Lamisil (Terbinafine HCl), and Sporanox (Itraconazole). Lamisil is a new fungistatic (stops growth of fungi) and fungicidal (kills fungi) which may replace Diflucan as the drug of choice for treating Candidiasis. Nystatin is the weakest antifungal and many yeast are resistant to it.

Sinusitis

Chronic rhinosinusitis, potentially an immune disorder triggered by airborne fungus, was effectively treated with antifungal medications in a small randomized clinical trial. “We demonstrated an improvement using antifungals in an objective finding for people with chronic rhinosinusitis,” lead author David A. Sherris, MD, interim chair of the department of otolaryngology at the University of Buffalo in New York, told Medscape. Dr. Sherris conducted the research while at the Mayo Clinic. The researchers hypothesized that airborne fungi initiate an immune reaction in the sinuses in certain people sensitive to chronic sinusitis.

In a randomized, placebo-controlled, double-blind study, 30 adult patients with chronic rhinosinusitis were either given 20 mL of amphotericin B, a fungicide, or a placebo squirted into the nasal cavity twice daily. Data were analyzed for 24 patients.

Researchers performed computed tomography (CT) of patients at baseline and at six months, and they conducted endoscopic examinations for inflammation at baseline, three, and six months. Based on CT findings, the researchers found that patients receiving the antifungal had an average reduction of 8.8% in the inflammatory mucosal thickening compared with an increase of 2.5% in those receiving placebo. Similarly, 70% of the patients receiving amphotericin had an improvement in endoscopy scores, while the placebo group showed no change. The treatment group also had significant reductions of intranasal mucus levels of interleukin-5 compared with the placebo group. [AAAAI 60th Annual Meeting: Abstract 1228. Presented March 23, 2004]

For 13 years, Dr. B. Manrin Rains, III, F.A.C.S., Director of the Mid-South Sinus Center and a member of the Methodist Healthcare – Memphis Hospitals medical staff, has pioneered alternative methods of treatment for non-invasive fungal sinusitis. His retrospective case review, “Treatment of Allergic Fungal Sinusitis with High Dose Itraconazole,” has been accepted for publication in the American Journal of Rhinology. Both this study and a second study, “Itraconazole Use in Non-Invasive Fungal Rhinosinusitis,” were funded through the Methodist Healthcare Foundation.

“Allergic fungal sinusitis (AFS) has only been recognized as a clinical entity for the past 20 years. Thus, there hasn’t been much information on how to treat it,” said Rains. “The common treatment was high-dose steroids, which unfortunately produce many adverse side effects including cataracts and accelerated osteoporosis. So out of necessity, we developed our own protocol.”

The protocol calls for use of oral itraconazole with short burst, low-dose steroids following endoscopic sinus surgery. The 234 patients participating in the study were treated under this protocol and showed positive outcomes. Whereas AFS has a recurrence rate of over 50%, the rate of revision surgery for patients on the new protocol was only 20%. The series was the largest ever reported in the U.S., and there were no serious adverse reactions.

“This suggests that itraconazole may reduce the need for repeat surgical intervention on patients with recurrent disease, thereby avoiding surgical morbidity and reducing treatment costs,” said Rains. He presently is evaluating the use of a topical itraconazole nasal spray in fungal sinusitis; recurrence rates are remaining low. “In addition, the topical version costs run a patient approximately $30 a month, whereas oral itraconazole can total $800 to $1500 for the full course of treatment. Also, topical itraconazole causes no elevation in liver enzymes.”

A compounding pharmacy may be able to provide such a preparation for your use, with your doctor’s approval.

Dysbiosis, Bacterial

Antibiotic drugs may either cause or help control dysbiosis, depending upon the drug and the nature of the disorder. Where contamination of the small bowel by anaerobes is the problem, metronidazole or tetracyclines may be beneficial. When enterobacterial overgrowth predominates, ciprofloxacin is usually the drug of choice because it tends to spare anaerobes. Herbal antibiotics may be preferred because of their greater margin of safety and the need for prolonged antimicrobial therapy in bacterial overgrowth syndromes.

Parasite, Dientamoeba Fragilis

Stool-positive ‘IBS-like’ patients underwent a combination therapy with iodoquinol and doxycycline and all became negative for DF. When interviewed at least four weeks after treatment, 16 of 21 patients reported global improvement post-treatment. After treatment with antibiotics for 16 patients with diarrhea-predominant IBS-type symptoms, 14 reported the resumption of regular bowel habit with a reduction in frequency to 1-2 stools per day and improvement in associated symptoms. Those with minor symptoms or with constipation failed to improve post-treatment suggesting another cause for their symptoms. [Borody TJ, Robertson C, Wettstein A, Warren E, Leis S and Surace R. (Winter 2002 Edition of Ibis News and Views, pp. 4-5]

Fungal Skin / Nail Infection

Many antifungal creams ( imidaole, naftidine, tolnaftate or nystatin) are available, and can be applied 2 -3 times a day for several weeks. Continue applying the cream for a week after the infections seems to have cleared. In the case of widespread skin infection, oral anti-fungal drugs may be prescribed by your doctor.

Rheumatic Fever

Antibiotics will not modify an acute rheumatic fever attack nor affect the subsequent development of carditis. However, a recommended regimen of antibiotics prescribed for treatment of streptococcal pharyngitis is recommended to eradicate any group A streptococci remaining in the patient, and in part, to prevent spread of the organism to close contacts.

Mycoplasma Infection

Doxycycline, tetracycline, clindamycin, lincomycin, and ciprofloxacin were found to be effective against Mycoplasma incognitus. But erythromycin, the antibiotic most commonly used to treat mycoplasma infections, was not effective and penicillin, streptomycin, gentamicin, and others also had no effect. Treatment is very long term compared to the typical course of antibiotic use.

For other mycoplasmas, doxycycline at 600mg per day is needed and anything lower and the patient does seem to need repeated and unhelpful courses.

Your sexual partner must also take a high dose to stop future transmission and reinfection. Condoms are recommended when sex resumes. Circumcised men are less likely to carry it but even so, may carry the organism, too, if they were once

infected by an infected female. Repeat episodes between you must stop because doxycycline may eventually stop working.

Parasite Infection

Sometimes, depending on the organism, conventional antiparasitic drugs may be the most reliable approach to effectively killing the parasite.

Chronic Inflammation

Please see the link between Inflammation, Chronic and Conventional Drugs about the use of low dose doxycycline (Periostat).

Inflammatory Arthritis

There are many stories of how long term use of an antibiotic such as minocycline has produced full recovery from inflammatory arthritis.

Neutrophilia

Neutrophils are the primary white blood cells that respond to a bacterial infection, so the most common cause of marked neutrophilia is a bacterial infection.

Antibiotic Need

Schizophrenia

The Independent – March 2, 2012.

A cheap antibiotic normally prescribed to teenagers for acne is to be tested as a treatment to alleviate the symptoms of psychosis in patients with schizophrenia, in a trial that could advance scientific understanding of the causes of mental illness.

The National Institute for Health Research is funding a £1.9m trial of minocycline, which will begin recruiting patients in the UK in April 2012. The research follows case reports from Japan in which the drug was prescribed to patients with schizophrenia who had infections and led to dramatic improvements in their psychotic symptoms.

The chance observation caused researchers to test the drug in patients with schizophrenia around the world. Trials in Israel, Pakistan and Brazil have shown significant improvement in patients treated with the drug.

Scientists believe that schizophrenia and other mental illnesses including depression and Alzheimer’s disease may result from inflammatory processes in the brain. Minocycline has anti-inflammatory and neuroprotective effects which they believe could account for the positive findings.

Rheumatoid Arthritis

Antibiotic therapy has been controversial. Doctors haven’t proved, or disproved, that an infection causes rheumatoid arthritis. Early studies of minocycline showed only a modest effect, discouraging many physicians, said Dr. Doyt Conn of The Arthritis Foundation.

Most rheumatology investigators believe that an infectious agent causes rheumatoid arthritis. There is little agreement as to the involved organism. Investigators have proposed the following infectious agents: Human T-cell lymphotropic virus Type I, rubella virus, cytomegalovirus, herpesvirus, and mycoplasma. There is evidence supporting the hypothesis that mycoplasma is a common etiologic agent of rheumatoid arthritis.

Minocycline is a more potent antibiotic than tetracycline and penetrates tissues better. These characteristics shifted the treatment of rheumatic illness away from tetracycline to minocycline. Minocycline may benefit rheumatoid arthritis patients through its immunomodulating and immunosuppressive properties as well.

Thinking that treatment earlier in the disease might work better, 46 patients were treated who had rheumatoid arthritis for less than a year and were not taking strong arthritis medicines. Sixty-five percent of the minocycline patients showed a 50% improvement in joint swelling, stiffness and pain after six months of therapy. Just 13% of patients given a dummy pill had a similar response. How long improvement lasted was key, because many other treatments either wear off or eventually cause serious side effects. Over a period of three years, 44% ultimately improved by a dramatic 75% or more.

Such improvement over time is encouraging, said Dr. Eric Schned, a Minneapolis rheumatologist who has followed O’Dell’s work.

The definitive scientific support for minocycline in the treatment of rheumatoid arthritis came with the MIRA trial in the United States. This was a double blind randomized placebo controlled trial done at six university centers involving 200 patients for nearly one year. The dosage they used (100mg BID) was much higher and likely more effective than what most clinicians were using. They also did not employ any additional antibiotics or nutritional regimens, yet 55% of the patients improved. This study finally provided the “proof” that many traditional clinicians demanded before seriously considering this treatment as an alternative regimen for rheumatoid arthritis.

Diverticular Disease

The infection causing diverticulitis often clears up after a few days of treatment with antibiotics. Diet then becomes the chief form of treatment to prevent further episodes.

Rheumatic Heart Disease

Those people who have already suffered a rheumatic fever attack are extremely susceptible to a recurrence if they are again infected with group A streptococci. Patients who have experienced a documented acute rheumatic fever attack should receive continuous antibiotic prophylaxis to prevent streptococcal infections at least until reaching adulthood or at least 5 years after their most recent attack. Patients whose acute rheumatic fever attack has left them with damaged heart tissue may need lifelong antibiotic prophylaxis. Invasive dental or surgical procedures may require additional antibiotic prophylaxis for patients with rheumatic valvular heart disease.

Prostatitis

If you have acute bacterial prostatitis, you will usually need to take antibiotics for 7 to 14 days. Almost all acute infections can be cured with this treatment. Analgesic drugs to relieve pain or discomfort and, at times, hospitalization may also be required.

The treatment of chronic bacterial prostatitis can require antibiotics for a longer period of time, usually 4 to 12 weeks. About 60% of all cases of chronic bacterial prostatitis clear up with this treatment. For cases that don’t respond to this treatment, long term, low dose antimicrobial therapy may be recommended to relieve the symptoms. In some cases, surgical removal of the infected portions of the prostate may be advised.

Bronchitis, Acute

Patients suffering from bronchitis who were given a widely prescribed antibiotic (Zithromax) did no better than patients who took a low dose of vitamin C, which is known to be ineffective in treating bronchitis. Physicians commonly prescribe antibiotics to treat this condition, but prior studies of whether antibiotics help patients with bronchitis have had mixed results. The patients were also given standard therapy for bronchitis, including cough syrup and an albuterol inhaler to ease their cough.

Researchers found that after 7 days, the patients given the antibiotic and those given vitamin C did not differ significantly in their physical improvement and the timing of their return to regular activity. If there is a suspicion of pneumonia, the patient should be reassessed. Sometimes pneumonia is misdiagnosed as acute bronchitis. [The Lancet May 11, 2002;359: pp.1648-1654]

Boils, Abscesses, Carbuncles

Antibiotics are usually prescribed to treat a bacterial infection, antifungal drugs to treat fungi, and antiamebic drugs to treat amebiasis. However, the lining of the abscess cavity tends to reduce the amount of drug that can penetrate the source of infection from the bloodstream.

Boils often resolve by themselves, but severe or recurring cases require medical treatment. Options include lancing and draining the boil, and antibiotics. Some people have multiple or recurrent boils. In these cases antibiotics are taken by mouth for 10 or 14 days. Stubborn cases may require two oral antibiotics plus topical antibiotic ointments to eliminate the bacteria.

Interstitial Cystitis

The following is excerpted from an interview with B.J. Reid Czarapata, CRNP, CUNP, President, Urology Wellness Center.

I truly believe in the bacterial theory as a contributor to the IC condition. I do not particularly believe that IC is a urinary tract infection. The cultures are negative because not all bacteria grow well on an agar culture medium. (Agar is a solid growth medium used for some culturing techniques). It stands to reason that bacteria that grow in urine may prefer a fluid medium. So, we have taken from Dr. Fugazzotto’s work, where he grows bacteria in a soy broth medium.

Dr. Fugazzotto (who is now deceased) found that two main bacteria are found in interstitial cystitis patients. These were an Enterococcus and a Micrococcus. He found that when these people were treated with culture specific antibiotics that they got better. I wish to point out that these bacteria are gram positive bacteria. Most physicians will treat a UTI with antibiotics for gram negative bacteria, such as Bactrim

Dr. Fugazzotto had done a significant amount of work. He has published some of it. We have an independent lab in the metropolitan Washington DC area that uses Dr. Fugazzotto’s methods. We have gotten the same results. Most of the patients have a Micrococcus or Enterococcus infection. When we treat these with specific antibiotics, our patients are getting better.

I do wish to add that if we only treat with antibiotics patients get better but not all the way better and they frequently relapse when the antibiotics are stopped. However, if we treat with antibiotics in conjunction with the other treatments that we use, such as diet, biofeedback, pelvic floor rehabilitation, trigger points, exercises and treatment of yeast, etc., then the people seem to get 90 to 95% better.

When I use the antibiotics, I always use a yeast medication with it. An oral yeast medication. My preference is for Nystatin oral powder or oral tablets. Over the 7 years I’ve been in private practice and the approx. 400 patients I have treated, I have seen no resistances and only maybe 5-8 patients with some complications.

If the biopsies show positive for Mycoplasma or Ureaplasma, high dose doxycycline should be used. All the patients I have ever counselled with so-called Interstitial Cystitis have been found to have a species of these two organisms, Mycoplasma or Ureaplasma, upon correct urine sampling and vaginal swabbing. [Angela Kilmartin, authour of The Patient’s Encyclopedia of Urinary Tract Infection, Sexual Cystitis and Interstitial Cystitis]

People who have tried this antibiotic have reported that they have been helped by high dose doxycycline (100mg 6 times a day for 6-10 days), but others concluded that they were not helped.

Susceptibility To Miscarriages

Antibiotics may be prescribed to treat infections in the mother, which can be a cause of miscarriages.

Vaginitis/Vaginal Infection

There are no OTC medications for Bacterial Vaginosis . The usual prescriptions are metronidazole (flagyl – orally or as a gel) or clindamycin. Local applications are preferred due to reduced likelihood of side-effects.

Vulvodynia / Vestibulitis

Vulvar pain that is due to infection e.g. ureaplasma, candida or strep will respond to the appropriate treatment.